Nutritional status and body composition of patients hospitalized due to exacerbated heart failure

Wawrzeńczyk, Anna; Kowalczyk, Gabriel; Szukay, Beata; Banaś, Wioletta; Tojek, Krzysztof; Budzyński, Jacek

doi:10.20452/pamw.16132

Cited by 3 publications

(3 citation statements)

References 12 publications

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“…Looking at the other side of the coin, as mentioned above, 7%-15% of the general population may suffer from CKD (defined as GFR <60 ml/min/1.73 m 2 ) -the prevalence rises to as high as 35%-55% in patients with HF, both with preserved (HFpEF) and reduced (HFrEF) ejection fraction [12][13][14][15]. These epidemiological data have been reproduced by the key HF trials with SGLT2i (Table 1) [16][17][18][19]. The four pivotal HF trials with SGLT2i reflect real life practice when looking at their renal aspects and should convince the medical community that CKD is the leading comorbidity in the HF population.…”

Section: Chronic Kidney Disease and Heart Failure: Modern Civilizatio...mentioning

confidence: 82%

Kidneys in heart failure: Impact of flozins

Stompór,

Winiarska

2023

Kardiol Pol

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Chronic kidney disease (CKD) and heart failure (HF) represent two modern diseases of civilization and are closely related. According to the concept of cardio-renal and reno-cardiac syndromes, most patients with CKD are affected by cardiovascular disease (CVD), and CVD (including HF) is one of the factors not only promoting progression of established CKD but also triggering its onset and development. Treatment of CVD and HF in CKD patients remains challenging since CKD patients are characterized by extremely diverse and strongly expressed risk profiles, and the data from well--designed clinical trials addressing this population are scarce. Nevertheless, it seems that most of the drugs used in the treatment of CVD and HF (including beta-blockers, angiotensin-converting enzyme [ACE] inhibitors, angiotensin II receptor blocking agents, mineralocorticosteroid receptor antagonists, and sacubitril/valsartan) are of similar efficacy in patients with glomerular filtration rate (GFR) ranging between 45 and 60 ml/min/1.73 m 2 (although higher prevalence of side effects may limit their use). The data on cardiovascular (CV) drug efficacy in patients with lower GFR values (i.e., below 30-45 ml/min/1.73 m 2 ) remain limited. In this review, we focused on the efficacy of sodium-glucose cotransporter 2 inhibitors (SGLT2i) in the treatment of CVD and HF in CKD patients with or without diabetes. SGLT2i are clearly cardioprotective in a wide spectrum of estimated GFR although the data for HF patients with respect to urine albumin-creatinine ratio (UACR) are scarce, and for those with significantly reduced estimated GFR are still not available or not convincing, even after completion of large-scale high-quality major cardiovascular outcome trials (CVOT) in type 2 diabetes mellitus (T2DM) or trials with flozins in CKD and HF.

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Section: Chronic Kidney Disease and Heart Failure: Modern Civilizatio...mentioning

confidence: 82%

Kidneys in heart failure: Impact of flozins

Stompór,

Winiarska

2023

Kardiol Pol

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“…Moreover, increased WHtR is a better predictor for the risk of metabolic disorders (diagnostic value in descending order: WHtR > WHR > WC > BMI) [42]. In addition, WHtR is more strongly associated than BMI with obesity-associated mortality in patients with heart failure [43][44][45], and with diabetes, diabetic nephropathy, hypertension, and dyslipidaemia, [2,46]. It should be underlined that some authors report that A Body Shape Index (ABSI) or Body Roundness Index (BRI) surpasses WHtR in relation to the usefulness of anthropometric nutritional parameters as prognostic and risk factors for cardiovascular and cancer mortality [32,47].…”

Section: Discussionmentioning

confidence: 99%

Nutritional and functional status as indices of short- and long-term prognosis in patients undergoing surgery due to colorectal cancer

Szukay

Tojek

Kowalczyk

et al. 2022

Medical Research Journal

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Introduction: Nutritional status and body composition parameters would seem to be reasonable prognostic factors in patients with colorectal cancer (CRC). The study aimed to investigate the relationships between numerous parameters of nutritional status and prognosis in patients undergoing surgery due to CRC.Material and methods: Clinical nutritional assessment and biochemical determinations were performed on 110 patients who underwent elective surgery due to primary CRC. Body composition was also analyzed using bioelectrical impedance (BIA) and computed tomography (CT) scans at the third lumbar (L3) vertebra using OsiriX software.Results: Patients who failed to attend a visit 3 months after surgery (n = 15; 13.6%) were more likely to be sarcopenic, with lower baseline functional status, handgrip strength, skeletal muscle (SM) parameters in BIA and a smaller SM area in CT. Compared to those who died during, on average, 3.6 years of follow-up (n = 33; 30%), patients who survived had, at baseline, a significantly higher Mini-Nutritional Assessment (MNA) score, lower waist-to-height ratio (WHtR), and higher scores on functional status scales. In a Cox's proportional-hazards model, in addition to an advanced WHO CRC stage, scores for MNA (HR; 95% CI: 0.85; 0.74-0.98; p = 0.021), Patient-Generated Subjective Global Assessment (PG-SGA), instrumental activities of daily living (IADL), and WHtR (3.68;; p = 0.049) were independent risk factors for death.Conclusions: Patients' functional status 3 months after surgery due to CRC was related to baseline SM strength, mass, and functional performance, whereas 3.5-year mortality was associated with lower MNA and IADL scores and higher WHtR and PG-SGA scores.

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“…It can also be used to assess the optimal body weight of hemodialysis patients, though it is controversial whether BIS guided volume management may improve the survival outcome or prognosis of cardiovascular diseases [5]. The con icting results may partially be explained by the reason that BIS dose not directly evaluate the intravascular volume or cardiac load, and the total body composition may be in uenced by factors such as nutrition status or cardiac function [6,7]. To this end, the biomarkers for blood volume assessment need further investigation.…”

Section: Introductionmentioning

confidence: 99%

Brain natriuretic peptide reflects volume status and influences on survival of hemodialysis patients

Wang

Chen

2022

Preprint

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Background Periodic volume accumulation is a characteristic feature of hemodialysis. Aim of the study was to investigate the relatively normal range of brain natriuretic peptide (BNP) in hemodialysis patients and to explore its role in volume management. Methods Patients on hemodialysis were enrolled. Normal range of BNP was deduced from patients with normal volume status defined by systolic blood pressure (SBP) and over hydration (OH). Hemodialysis patients were classified according to BNP expression at baseline and followed-up for 57 months. The outcome was defined as all-cause mortality, and cardiovascular disease related death. Results Pre-dialysis BNP and BCM measurement was conducted in 127 hemodialysis patients. BNP significantly correlated with OH in total patients (r = 0.255, P = 0.004). In patients with appropriate volume load, the average of BNP was 701 (± 645)pg/ml, with the 95% confidence interval (CI) of 500 ~ 902pg/ml. In patients with BNP < 902pg/ml, SBP significantly correlated with OH. Patients with BNP ≥ 902/ml showed increased risk of all-cause mortality (HR = 3.151, P < 0.001) and cardiovascular mortality (HR = 7.381, P < 0.001). Reduced BNP expression during the first year after baseline resulted in significantly decreased all-cause mortality. Conclusion Pre-dialysis measured BNP levels are associated with volume status, and normal range is from 500 to 902pg/ml. Patients with upregulated BNP expression showed increased risk of all-cause mortality and cardiovascular death. To reduce BNP expression to normal range showed protective effect on all-cause and cardiovascular mortality in long-term observation.

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Nutritional status and body composition of patients hospitalized due to exacerbated heart failure

Cited by 3 publications

References 12 publications

Kidneys in heart failure: Impact of flozins

Kidneys in heart failure: Impact of flozins

Nutritional and functional status as indices of short- and long-term prognosis in patients undergoing surgery due to colorectal cancer

Brain natriuretic peptide reflects volume status and influences on survival of hemodialysis patients

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